Five-time salivary gland cancer survivor faces life with a smile

Kelly Mireles’ smile is the facial feature most people notice when
first meeting her. That alone is a minor miracle.

Kelly had most of her jawbone removed in March 2015 after a salivary gland cancer recurrence. Her mandible
was rebuilt by MD Anderson surgeons in May 2016 using part of her
fibula, a non-weight-bearing leg bone. Today, with the help of an oral prosthesis, Kelly is able to eat, speak and
even smile again.

“I had a really hard time with it at first, and in some situations,
I still feel a bit self-conscious,” Kelly admits. “But even when I had
scars and a brace on my face, I went out and did things. I tried not
to let cancer affect who I was and what I wanted to do.”

A salivary gland cancer diagnosis

Kelly first noticed a lump on the right side of her face in late
2008. She saw a dentist, an ENT and a chiropractor, who ruled out
tooth and sinus problems, as well as TMJ. But they also offered her no
other possible causes.

It took mentioning a twitching eye and a trembling lip to her
gynecologist to finally get answers. “He sent me to an ENT oncologist,
who did some scans,” Kelly says. “Sure enough, there was a tumor.”

Kelly was diagnosed with stage I adenocarcinoma on her right parotid
gland — a rare oral cancer in the primary salivary gland — in October
2009. She had surgery near her home in San Antonio, followed by
chemotherapy and radiation. But the cancer returned four more times
over seven years, which required more surgeries, more chemotherapy and
more radiation.

When the salivary gland cancer returned the last time in February
2016, her plastic surgeon had just moved to Houston and her ENT
oncologist had stopped practicing. “I figured that was a sign we
needed a different set of eyes looking at this,” Kelly says.

Fourth recurrence leads to MD Anderson

Kelly called MD Anderson in March 2016 and made an appointment with
Carol Lewis, M.D., Patrick Garvey, M.D., and the rest of her care
team. They recommended surgery to remove more of Kelly’s jawbone and
create a new one using her fibula. After that, she’d receive
concurrent chemotherapy and proton therapy.

“Doing chemo and proton therapy at the same time was the most brutal
treatment I’ve ever experienced,” Kelly says. “But I needed something
aggressive because I couldn’t keep doing this.”

The surgery took place in May 2016, and Kelly began six weeks of
daily treatments at the Proton Therapy Center. She also started taking
low doses of the chemotherapy drug Taxotere, and she considers herself
lucky that she didn’t really lose her hair this time.

“It just thinned a little bit, and I never felt nauseous,” she says.

Dealing with diet restrictions

The hardest part for Kelly has been learning what she can and can’t eat.

“I have all my top teeth and two on the bottom in the very back, so
I can still chew things, even without the prosthesis,” she explains.
“But I have a very dry mouth, so I always have to have water.”

To avoid irritating her mouth and tongue, Kelly eats only very bland
foods. Sauces, seasonings, chocolate, carbonated drinks and alcohol
are things of the past.

“I love food, so it’s been a challenge,” she says. “And I’m a huge
Italian food person, but I can’t eat any of that. I can eat a steak if
I cut it up small enough, but it’s still a very limited diet.”

Making peace with her ‘new normal’

Today, Kelly has made peace with both her appearance and her dietary
restrictions. She’s had no evidence of disease for seven months, and
she’s grateful to have more time with her children.

“Honestly, it’s a blessing I’m even here,” she says. “With my type
of cancer, statistics say I shouldn’t have even survived the second
round, much less the fifth, so I accept what I have.”

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